Moving on Program from Supportive Housing (MOSH): Practice & Program Strategies Arlington

8/12/2020

Moving On Program from Supportive Housing
(MOSH):

Practice & Program Strategies
Arlington

S ub sta nt i a l se c t i o ns of t hi s po we r po i nt we re ad apte d fro m T i de r i n gto n, E e t al , “ M o v i ng o n from S up po r t i ve H o usi n g ”, R ut ge rs Un i ve rsi t y, 2018.

A nd re a W hi te

Email: [email protected]

1

Agenda

. Introductions . What is Moving On? . Why Implement Move On Strategies? . Program Strategies

...

Core Program Features Stages of Moving On Creating a Culture of Moving On

. Practice Interventions

....

Identifying Candidates and Assessments Pre-MOSH Planning Finding Housing Post-MOSH Planning

. Closing

2

1
8/12/2020

Zoom, zoom zoomerating

◦ We will mute all of you at the beginning of the presentation. ◦ We will pause periodically through the presentation for polls, questions and discussions.
◦ If questions come up during the presentation, please write them in the chat box. ◦ The slides and resource materials will emailed out after the session by The Planning Council.

3

Thoughts on

Problem Solving Skills

Last Week:

Tenancy Skills and Resources Developing a Network of Care Pro-Active Housing Planning Crisis Planning

Stabilizing in PSH

Housing Stabilization Session

••

Thoughts

Mentoring for Services Going Forward

Reflections

4

2
8/12/2020

Introductions Poll

.Why are you here today?

. I have tenants ready to move on . I have no tenants ready to move on . I want to start a moving on program at my housing authority

. I want to start a moving on program at my agency

. I am curious about the program model . Our system has no vacancies in PSH
(permanent supportive housing) and we need to get some flow to house high need people

. My boss told me to come

. None of the above – please type in chat box

5

What is Moving On?

◦ Help tenants who no longer require on-site services to transition from supportive housing to private apartments with, or without, rental support and less intensive community-based services.

◦ Allows providers to then fill now-empty units with people who are most in need of supportive housing. (CSH, 2016)

◦ Has become a HUD focus – question in 2019 Continuum of Care NOFA Competition

◦ Earliest efforts starting almost 20 years ago

6

3
8/12/2020

What is Moving On - 2?

.Spirit of Moving On

.Recovery-oriented .Promotes self-determination .An individualized process .Voluntary .Self-directed by the consumer .A process that starts at move in

7

Moving On – Paying for Housing

◦ Many people need a long-term/permanent subsidy

◦ Set asides of Section 8/Housing Choice vouchers ◦ Units in affordable properties

◦ Employment ◦ Back pay from mainstream benefits ◦ Family reunification ◦ Major life changes- marriage, new relationship, children, etc.

◦ VA Home Loans

8

4
8/12/2020

Financial support for moving expenses like:

◦ Security deposits ◦ First and last month’s rent

Moving On – Services and Financial

◦ Purchasing household items: furniture, dishes, appliances

Case management support for:

◦ Identifying, securing and setting up the new home and acclimating to the neighborhood

Assistance

◦ Increasing income ◦ Help with developing positive relationships with landlords ◦ Providing education on financial management and tenancy rights/responsibilities

◦ Crisis planning, negotiation, problem-solving, refusal and conflict resolution skills
◦ Bridging resources ◦ Establishing new goals, routines and connections to formal and informal supports
◦ Building confidence in succeeding

9

Pause for questions and comments.

How many of you are doing moving on already? If so, what has been most important in your direct practice with participants?

Please indicate in the chatbox or raise your hand if you would like to comment.

10

5
8/12/2020

Features of a Successful Moving On Program

◦ Moving on is introduced at the beginning of tenancy in supportive housing and discussed regularly during service plan reviews

◦ Focus on consumers who will be successful ◦ Requires all hands-on deck! ◦ Strong communication ◦ Training in Evidence Based Practices

◦ Critical Time Intervention ◦ Motivational Strategies using Motivational Interviewing Tools

◦ Culture of Moving On ◦ Peer Support

11

Stages of MOSH

Adapted from Stages of Change - Prochaska, J.O. & DiClemente, C.C. (1983). Transtheoretical therapy: Toward a more integrative model of change. Psychotherapy: Theory, Research and Practice, 20, 161-173.

Maintenance

I know how to do this!

Action

I’m out of here!

Preparation

What do I have to do

Contemplation

to get out of this place?
Maybe I would like to get my own place one of these days.

Pre-Contemplation

Why Move On? I just got here!

Stages of Moving On from Supportive Housing

12

6
8/12/2020

Stages of MOSH: Pre-Contemplation

Pre-contemplation : A person has not yet identified

an issue as a problem and is not currently considering change.

Staff Roles:

◦ Introducing consumers to the idea of MOSH ◦ Educating consumers about MOSH options ◦ MOSH success stories ◦ Using open ended questions to help consumers think about future goals

13

Stages of MOSH: Contemplation

Contemplation : A person begins to identify an issue as a problem and is thinking about but ambivalent about change.

Staff Role ◦ Exploring ambivalence

◦ Have conversations about what is expected to move out and be realistic - budgeting, finances, etc. Bringing these things to life really motivates people to think if they are ready and make their own decision (CSH, 2016)

◦ Use “Decisional Balance Sheet” to explore the Pros and Cons of staying and of moving on

14

7
8/12/2020

Decisional Balancing

Benefits

Costs

Staying in Supportive Housing

Moving On from Supportive Housing

Elicits statements of Why consumers want to Move On

15

Challenges and Benefits of Moving On

CHALLENGES

BENEFITS

◦ Loss of connections with the
◦ Freedom from service providers

◦ Increased independence ◦ Safer, more peaceful environment ◦ Reunite with family/friends ◦ Better access to work/services etc. ◦ More social/community integration community
◦ Increased responsibility ◦ Managing mental and physical health conditions
◦ Housing/neighborhood quality can decrease
◦ Moving On is expensive
CSH, 2016

Tiderington, Livingstone, & Herman, 2017

16

8
8/12/2020

Importance and Confidence Ruler

Importance Ruler:

◦ “On a scale of 1 to 10, how important is it for you to Move On from PSH”

◦ “Why are you a ____ and not ___?”

◦ Your number should be 2-3 digits lower than the consumer's

Confidence Ruler:

◦ “On a scale of 1 to 10, how confident are you that you can Move On from PSH”?

◦ “Why are you a____ and not ___”?

◦ Your number should be 2-3 digits lower than the consumer's

◦ “What would it take for you to be a _____”

◦ Your number should be 2-3 digits higher than the consumer’s

17

Stages of MOSH: Preparation

Preparation : A person is planning to make a

change. They seek out information and support, they are “testing the waters.”

◦ Be trauma-informed and educate your consumers on what to expect during the MOSH process
◦ Planning support for the process ◦ Consumers in this stage usually have the capacity to save money and are tenants in good standing, up-todate on their rent, etc^.

18

9
8/12/2020

Stages of MOSH: Action

Action : A person actively begins making changes in his or her life. They are practicing new behavior(s).

◦ Making a Pre-MOSH Service Plan

◦ Securing Income and Benefits ◦ Budgeting/Financial Planning ◦ Enhancing Tenancy Skills ◦ Resolving Tenancy Barriers ◦ Executing the Housing Search Process

◦ Creating a Post-MOSH plan to be executed after moving on in maintenance phase

◦ Connecting to External Support Services and Resources ◦ Eviction Prevention ◦ Crisis Planning ◦ Income Growth

19

Stages of MOSH: Maintenance

Maintenance/Relapse: A person sustains behavior change OR

a person resumes old behaviors. Relapse is considered a part of the change process.

Staff Roles

◦ Check-ins and aftercare: formalize this process ◦ Updating the Post-MOSH Plan ◦ Relapse prevention plan, as it relates to housing ◦ Eviction prevention planning

20

10
8/12/2020

Polls

◦ Do you have tenants in your program who could successfully move on? ◦ Do you have participants in your program who are already in the Preparation or Action stage?
◦ Please use chat box to elaborate or indicate if you would like to comment.

21

Creating a Culture of Moving On

Strategies
◦ Integrate Moving On into service plan discussions ◦ Publicize and celebrate moving on opportunities ◦ Moving On group for peer support ◦ Bring back alumni to meet with potential movers ◦ Peer-run alumni activities (e.g., celebrating holidays, etc.) ◦ Integrating MOSH into your supervision

People are resistant to change. Moving On usually requires a significant organizational culture shift, and it starts with people who have already done Moving On.

◦

Must do cost/benefit analysis

22

11
8/12/2020

◦ Losing your favorite consumers ◦ Fearing they won’t succeed without you ◦ Lack of community resources for support post move on

Challenges for Providers

◦ Lack of affordable housing ◦ Housing Authority not engaged ◦ Additional workload – getting new higher need tenants and following people who have moved on
◦ Lack of funding ◦ Organizational culture/mission conflict

23

◦Provides “churn” so others can access supportive housing units
◦Landlords/PHA serve homeless system and tenants who have successful track record as a tenant/following a lease

Benefits for the Provider and System

◦Helps people achieve a “life after case management”
◦Staff feel a sense of success in their work ◦Follows the aim of the recovery model to encourage people to move forward
◦Can serve higher-need more vulnerable people in vacated supportive housing units
◦

24

12
8/12/2020

Pause for discussion

*How does this align with your agency’s mission? *How will you “sell” this in your agency? * What reservations do you have about Moving On? * What reservations do you think your leadership will have? Your staff? *What else do you need from your supervisor, your agency, or the CoC to be able to make Moving On part of your work?

Please indicate in the chatbox or raise your

^{hand if you would like to comment}.

25

Identifying Candidates for MOSH

Not all people are candidates, but more are than you may think ◦ People with the desire and motivation to move on ◦ Individuals with good financial management skills ◦ Individuals with stable incomes, preferably employment but can be SSI/SSDI if rent subsidies/affordable units are available or person is willing to have roommates/live with others

Individuals who have demonstrated the ability to maintain housing

◦ Individuals who have been able to follow their leases, manage their units and meet their responsibilities for a sustained period of time

Individuals no longer in need of on-site services Individuals with portable vouchers Family reunification cases

26

13
8/12/2020

Assessing for Moving On

◦ Housing Plan and Goals ◦ Household Composition ◦ Income Sources and Amounts ◦ Debts ◦ Tenancy History and Lease Compliance ◦ References

27

I have a consistent source of income I have at least one month’s worth of rent saved in a bank account

SelfAssessment

I have the benefits in place that I need I am employed OR receive disability, if unable to work I have good credit I pay my rent on time I pay my utility bill payments on time The police have never been called to my apartment and I consider myself a good neighbor

* Yes or No

I understand the terms of my current lease in supportive housing I have a primary care doctor and go to annual check ups I am able to manage my doctor appointments without the help my case manager

*Steps I need to take to work on this

If I was having trouble with my mood I would know where to get help I am able to manage my medications without the help of my case manager I have connections in the community outside of my case manager that I can go to for help. (e.g. family, friends, AA, Sponsor, church, etc.) I have no legal issues that would impact my ability to move out I know how to navigate public transportation or have a car of my own I am able to live independently and keep my apartment clean I have food at all times in my apartment

28

14
8/12/2020

Creating a Pre-MOSH Plan

Informed by the MOSH Self Assessment Should focus on the areas identified by the consumer Can be used to supplement the service plans already in place at your organization Once the MOSH Self Assessment is completed, review the answers with the consumer and turn the areas of concern into SMART goals with specific methods to achieve these goals.

◦ SMART ( Specific, Measurable, Attainable, Realistic, Timely)

Possible Goal Areas:

◦ Financial Capability ◦ Enhancing Tenancy Skills ◦ Resolving Tenancy Barriers ◦ Finding Housing

29

Pre-MOSH: Resolving Tenancy Barriers

Tenant screening is focused on the issues that are most important to landlords:

(Department of Veterans Affairs), 2017

30

15
8/12/2020

Pre-MOSH: Resolving Tenancy Barriers - 2

◦ Building/Repairing Credit ◦ Expunging Criminal Records ◦ Locating Eviction Records ◦ Positive Landlord/Property Manager Reference

◦ Preparing for Housing Interviews and Talking about Problematic Background issues

◦ Problem Solving Skills

31

Pre-MOSH: Resolving Tenancy Barriers - 3

Housing Retention Barriers are habits, or a lack of information or skills that are barriers to paying the rent, caring for the unit, interacting with the landlord or other tenants, and following the lease and the laws. Resolving Housing Retention Barriers often become a part of Pre-MOSH Plan.

(Department of Veterans Affairs, 2017)

32

16
8/12/2020

Pre-MOSH: Enhancing Tenancy Skills

◦ Social Skills Training (SST) works with consumers on how they perceive social cues, problem solving and analyzing the situation, and then responding effectively.
◦ SST uses role-plays, practice, feedback and guidance to strengthen individuals’ interpersonal skills.
◦ SST helps consumers negotiate for their needs, manage neighbor, landlord and other relationships effectively, essential skills to live independently

33

Stan Debate

◦ Successfully maintained tenancy ◦ Member of agency Advocacy Committee ◦ Engaged in mental health treatment ◦ Brought me cheese ◦ Sweet as pie ◦ History of victimization

◦ Poll: Should Bert Move On?

34

17
8/12/2020

Pre-MOSH: Finding Housing

Finding housing can be hard. Some techniques to identify new landlords, brokers, and management companies:

◦ Cold calls and word of mouth ◦ Keeping your eyes open ◦ Landlord networking meetings/landlord event ◦ Internet searches/brokers ◦ Network with other nonprofits and programs ◦ Teach your consumer how to do their own search ◦ Portable Section 8 vouchers

◦ www.gosection8.com

Develop a Landlord Benefits Document

35

Staying in the Same Unit/Transitioning in Place

◦ You may be able to help consumers transition their scattered-site supportive housing unit into their own apartment.
◦ Help them to talk to the landlord. Can the lease be renewed under the consumer’s own name? Can they afford to pay market rent for the unit on their own?
◦ Can they apply a voucher/subsidy to this unit?

◦ Bonus: These landlords already know the tenant and may be more willing to rent to them. They are already familiar with the neighborhood and community so they’ll have existing supports in place. Eases the trnsition

36

18
8/12/2020

Pre-MOSH: Finding Housing

Know Basics of Renting and Any Subsidies

◦ Broker’s fee: usually between 1 month’s rent and 15% of annual rent ◦ Security deposit: usually between 1 and 2 months of rent ◦ Most of the time it is illegal for large landlords to discriminate based on source of income. This includes vouchers! You should always get information about the price of the apartment before introducing that the future tenant plans to pay with a voucher.

Accompany people to view apartments, practice landlord interviewing skills, and attend lease-signing.

Familiarize yourself with Virginia Housing Laws with resources from Virginia Legal Aid:

◦ https://www.valegalaid.org/issues/housing/landlord-and-tenant-issues

A useful resource for training staff in basic housing rights is in Module 3 of SAMHSA’s PSH

Training for Frontline Staff which can be found here:

https://store.samhsa.gov/shin/content//SMA10-4510/SMA10-4510-03-TrainingFrontlineStaff-PSH.pdf

◦ - ADA, Fair Housing

37

Post-MOSH: Aftercare

Aftercare at Jericho Project, NY, NY

◦ Home visit during Month 1 ◦ Check-ins at Months 1, 2, and 3 ◦ Check-ins at Months 6, 9, and 12

Can use Critical Time Intervention (CTI) Model Focus on eviction prevention, lease compliance and support network Offer to help renew lease and if using a voucher, complete annual recertification and make sure landlord is aware Public Housing Authority (PHA) will be doing another inspection and assessment of rent reasonableness.

38

19
8/12/2020

Creating a Post-MOSH Plan

Connecting to Community Supports

◦ A ‘network of care’ is each person’s support system as they leave PSH. ◦ This will build on the resources and relationships developed in PSH. ◦ Helping people connect to resources (and resource gaps) is core to the EBP of CTI and essential for community stability.
◦ Look for both formal and informal supports ◦ Income, benefits, AND services ◦ Develop a person-focused resource list ◦ Review resources in current use ◦ Add resources developed through work with other tenants ◦ Identify needed connections

39

Post-MOSH: Planning for Termination and Stability

Start terminating Moving On support from the beginning. Make sure the consumer is aware of how often you will be checking in with them, and for how long.

Let them know that even after Moving On support has ended, they can always reach back out if they have questions or concerns.

Make sure they understand they cannot move back if there’s no “right of return.” As people are ready to move out we want to:

◦ Review work done together in PSH ◦ Ask each person to think evaluatively of their experience in PSH –

◦

what was helpful, what wasn’t, successes, challenges

◦ Hold meetings with the network of care to

◦

provide a handoff and plan for future support – “warm handoff”

◦ Develop longer term goals to give structure for moving forward ◦ Develop eviction prevention and crisis plans

40

20
8/12/2020

Themes for Participants

Building Skills

Pursuing Goals – Structure & Purpose
Changing Expectations

Developing
Assuming

New Roles
New
Connections

41

Post-MOSH: Celebrating the Move!

◦ Moving On is a huge accomplishment for both the consumer and staff, and it’s important we celebrate it!
◦ Have events to celebrate the successes of consumers who’ve moved on.
◦ Stay connected with agency events and celebrations.
◦ Invite tenants to come back and talk to potential consumers interested in Moving On.

42

21
8/12/2020

Keys to Successful Implementation

.Organizational buy-in and partnerships .Subsidies/subsidized units . Application/vetting process and coordination with CoC Coordinated Entry System

.Culture of Moving On in the organization

. Have ongoing discussions of Moving On with tenants (discuss at Service Plan Review)
. Teach tenancy skills and address barriers to tenancy . Use Peers/Alumnae to build motivation and skills . Develop move-on plans and connect to community resources

.Resources to provide aftercare (preferably

for at least 6 months) (note on funding)

43

Final Discussion

◦ Polls

◦ Are you interested in implementing a Moving On program in your community/agency?

◦ Discussion Q’s – Please indicate in the chat box if you would like to comment

◦ What questions do you have about implementing moving on?
◦ What resources do you need to help people move on?
◦ What barriers do you anticipate? ◦ How will you promote this idea?